Hormone replacement for the dastardly hot flashes and sleepless nights of menopause has been both common and controversial. But the latest touting comes from advocates who say replacing the hormones that our bodies stop making as we age is good for all kinds of things — from bone health to cardiovascular zest to better sex.

Keystone pharmacist Mary PreFontaine is sold on it. She’s one of four pharmacists in the state who has completed a fellowship in functional medicine and anti-aging with the American Academy of Anti-Aging Medicine. She specializes in helping men and women figure out the right hormone replacement regime, working with their doctors.

“Historically, our lifespan, before the Industrial Revolution, was 50 years,” PreFontaine, 46, said. “That’s when we lose all these hormones and get ready to die. Well, that’s OK if you’re going to die, but what if you live another 40 years and you want to be out dancing and traveling? You don’t want to dry up and fall apart. So you have to do something about it.”

What suffers when the hormone factory slows to a stall? Tissues, for one thing, PreFontaine said, especially genital tissues. There’s also an increased risk of osteoporosis. Even brain function depends on a certain level of hormones, she said — hence that foggy brain syndrome. Cardiovascular health is compromised, as well, she said.

That’s all pretty alarming, so you go to your doctor and say, “Hey — maybe I should replace my dipping hormones.”

Lasater’s medical practice is based on the use of bio-identical hormone replacement for healthy aging. Like pharmacist PreFontaine, he said replacing the hormones our bodies stop making makes us healthier and more vital as we age.

But the American Medical Association doesn’t buy it. A study conducted by the National Institutes of Health several years ago called the Women’s Health Initiative concluded that some hormone replacement is harmful, so the AMA decried the entire practice, he said.

Lasater sighed. “I feel like installing a big metal spike on my office wall that I can bang my head against,” he said.

Back at Keystone Pharmacy, PreFontaine practically gnashes her teeth at that study, a 15-year, multi-million-dollar project initiated in 1991 to research health problems of postmenopausal women.

The study on estrogen and progestin replacement concluded that it caused an increased risk of heart attack, stroke and breast cancer. The study included just two synthetic hormones: Premarin and Provera, PreFontaine said.

“But they applied the results of the study to all hormones,” she said. “They said hormone replacement increased the risk of breast cancer, but only the Provera did. It was a knee-jerk reaction. So physicians were told to only give hormones if they’re desperately needed and for a short time to help with hot flashes,” she said.

Dr. Steve Lasater

Lasater explained it as “painting things with too broad of a brush. It seeped into the thinking of doctors that hormones are bad.”

The hormone replacement therapy PreFontaine and Lasater support uses bio-identical hormones that are identical in molecular structure to the hormones women make in their bodies. Making these hormones starts with a natural substance, such as soy or yams, and then chemically altering it to be exactly like the hormones our bodies produce.

Patients sometimes gush about the results.

“I’ve been called a fairy godmother,” PreFontaine said with a laugh. “Women have said, ‘You gave me my life back.’ ‘You changed my life.’ ‘My husband thanks you.’

“I also have failures,” she added. “Sometimes I try all year to treat somebody’s symptoms with hormones and I can’t. So they turn to something else — acupuncture or herbal remedies.”

At Lasater’s PhysioAge office, the doctor hooks up his patients to a myriad of gizmos to determine their “real” body age.

“Skin elastometer?” he offered. He said it reveals the actual age of a person’s skin after all those years of baking in the sun.

Lasater was a family practice physician for 30 years before turning to the specialty of anti-aging. He offers a comprehensive assessment of the health of each major physiological system and then a tailored program of exercise, diet, nutritional supplements and bio-identical hormone replacement therapy to slow, and in some cases, he says, reverse the decline in their physiological age.

The initial consultation, which lasts three to four hours, costs $850; comprehensive lab tests are another $900. Lasater charges an $85 monthly maintenance fee for his ongoing support and consultation. He doesn’t accept insurance.

The hormones themselves, typically a cream men and women rub onto their skin a couple of times a day, generally cost $100 per month or less, he said.

“I can’t guarantee everyone who comes in here will live longer,” Lasater said. “But we can reverse the detrimental effects the middle-aged person has from low hormones. We can make some difference. It’s not just the years in your life. It’s the life in your years.”

“It’s amazing how many people give up that area of their lives when they don’t have to,” he said. “The kids are out of the house — have a little fun.”

Debby DeJonge

Debby Buck DeJonge rummaged in the back seat of her car and pulled out a big bottle of vitamin supplements called “Stay Young and Sexy.” The capsules, made by Health Freedom Nutrition, are part of her personal anti-aging regimen, along with bio-identical hormone replacement.

DeJonge, who once ran the Longevity Center on East Paris with her late husband, Robert, was at her class reunion recently, scrutinizing her former classmates.

“I looked around and could tell you who was on bio-identical hormone therapy,” said DeJonge. “Two women: One looked great. One looked phenomenal.”

DeJonge gives hormone replacement credit for everything from her energy and vitality to her young-looking skin, and she travels the country speaking on the subject. She’s blond and tan with a khaki dress cinched tightly at her tiny waist.
She doesn’t mince words when she holds forth on the value of hormone replacement. The people seated nearby in an Ada coffee shop got an earful as she continued.

“When you have low estrogen, you lose elasticity in your skin. You get a muffin top, your boobs droop. You get dry dock (her term for vaginal dryness). Brad Pitt could walk up to you with a bottle of champagne and you’d say, ‘Not tonight, honey.’”

The replacement hormones come in different forms. She prefers monthly injections. “I’ve taken capsules; I’ve done creams. It’s a discussion you have with your doctor,” she said.

When estrogen is low, she says, an unpleasant line-up of seven dwarves show up: “Itchy, Bitchy, Bloaty, Crabby, Saggy, Naggy and Baggy,” she recited.

She’s been replacing her hormones for six years. Ask her age and DeJonge gets cagey.

“I have a son, 28, a son, 27, and a daughter, 19,” she said with a grin. “So how young can that make me?

“Can you put hormone cream on and your wrinkles will go away? No. It works from the inside out,” she said. “It’s about feeling good and being productive in your own life. You have the energy to do things.”

Any side effects?

“Yes,” she said. “Happiness. Energy.”

DeJonge said people become frustrated by the “mixed bag” of opinions about bio-identical hormone replacement — which sometimes occur in one person.

“I’m an extreme optimist and an extreme pessimist,” said Dr. Michael Fossel of Ada, who has written extensively about anti-aging medicine and lectured on the subject all over the world. He was founding editor of the Journal of Anti-Aging Medicine and former executive director of the American Aging Association.

“Most of what we can do now for anti-aging is not all that sexy,” said Fossel, a medical consultant for Cerner Corp., a health care information technology business. “Things are on the horizon that’ll be much, much better.”

Fossel talked enthusiastically about cellular research that will allow doctors to help us grow new, younger knees, and science lab developments that will extend life by re-setting our genes. “In the lab, we can reverse aging,” he said. “It’s just beginning to break now.”

And hormones?

“The medical community poo poos it,” Fossel said. “If hormones go down with age, does that automatically mean we should boost them back up? It’s not that simple. There is some benefit, but it’s not all it’s cracked up to be. And there’s no evidence that it can reverse or delay aging.”

Fossel, 61, said he’s not replacing any of his dwindling hormones. “Maybe I should be,” he mused. “I don’t know.”

In the seven years she’s been in the field, pharmacist PreFontaine said she’s seeing more doctors coming around to hormone replacement. “It used to be a struggle to find a physician to work with a patient,” she said.

But even PreFontaine doesn’t believe hormone replacement is a miracle drug.